Coronary angiography after revascularization

Abstract

As a result of the high prevalence of coronary artery disease in the Western world and increasingly also in the developing countries, coronary artery revascularization, albeit complex and expensive, is one of the most frequent medical procedures. It is estimated that annually worldwide approximately 800,000 patients undergo bypass -surgery [1], and >1.5 million cardiac percutaneous interventions are performed. With the increasing success of these procedures and improved long-term results, it is no longer current practice to perform routine invasive follow-up examination after revascularization. Only patients with evidence of recurrent ischemia undergo coronary angiography. However, the decision to perform or withhold coronary angiography can be exceedingly difficult in patients who have a history of coronary artery revascularization. Commonly, the fact that coronary artery disease has been previously established will lead many physicians to liberally order invasive coronary angiography if their patients experience symptoms faintly reminiscent of angina pectoris. In this setting, coronary CT angiography increasingly plays a role for obtaining reliable information on coronary artery anatomy noninvasively. © 2010 Springer-Verlag London Limited.